February 2012
Notes from the Section
- Accessing our section discussion list on AARConnect has just gotten a lot easier. Go HERE for instructions on downloading our mobile app on your Blackberries, Androids, and iPhones.
- Speaking of AARConnect, have you completed your profile page yet? If not, take a few minutes to share some information about yourself and upload a picture.
- AARC Executive Director Sam Giordano, MBA, RRT, FAARC, will retire in June and the search is on for his replacement. If you are interested in applying for the position, CHECK OUT the application requirements.
LCI Detects Early Lung Disease in CF
Australian researchers publishing ahead of print in the American Journal of Respiratory and Critical Care Medicine find the lung clearance index (LCI) is useful in detecting early lung disease in children with cystic fibrosis. The LCI was determined after multiple breath washout (MBW) testing in 47 presymptomatic/minimally symptomatic infants and young children with CF and 25 healthy controls. CF children underwent bronchoalveolar lavage (BAL) as well. The mean LCI in children with CF was 7.21 vs. 6.45 in the controls. The upper limit of normal for LCI was 7.41. Among the 47 children with CF, 32% had an elevated LCI. Measurements of LCI were repeatable and reproducible. Airway infection was detected in 36% of the children with CF, including 15% who had Pseudomonas aeruginosa infection. The LCI in children with Pseudomonas was 7.92 vs. 7.02 in children without Pseudomonas. The LCI was significantly correlated with interleukin-8 and neutrophil count in the BAL fluids. READ PRESS RELEASE
Pulmonary Function in Patients with Ankylosing Spondylitis
Researchers who compared pulmonary function studies in 147 patients with spinal condition ankylosing spondylitis (AS) and 121 healthy controls found significantly lower pulmonary function values in the AS patients. More AS patients were categorized with the restrictive pattern, as well, 18% vs. 0%. Further study revealed significant associations between spinal mobility measures and FVC% in individual patients, and the variation in FVC% was linked to the Bath ankylosing spondylitis metrology index, chest expansion, and male gender. Disease activity, physical function, and VO2peak were not significantly associated with the variation. Forty-five percent of the variance in FVC% was explained in the final model. “The results support the assumption of an association between musculoskeletal limitations and restrictive respiratory impairment in AS, emphasizing the importance of maintained spinal flexibility in the management of the disease,” write the authors. “Further, patients with severely reduced spinal mobility should be referred to pulmonary function examination and relevant follow-up treatment.” The study was published ahead of print in Arthritis Research & Therapy on Jan. 25. READ ABSTRACT
New Tool Measures Asthma Severity
The latest findings from the National Institutes of Health-supported Inner City Asthma Consortium suggest a new instrument called the Composite Asthma Severity Index (CASI) can be used to assess asthma severity and provide a composite clinical characterization of asthma in children and adolescents. The index includes five domains: day symptoms and albuterol use, night symptoms and albuterol use, controller treatment, lung function measures, and exacerbations. At baseline, the CASI ranged from 0 to 17, with a mean of 6.2, and remained stable after one year of treatment. During an external validation arm of the study, the CASI detected a 32% larger improvement than did symptoms alone. The study was published ahead of print by the Journal of Allergy and Clinical Immunology on Jan. 11. READ ABSTRACT
Questionable Cleaning
Spirometers used in the primary care setting may not be getting proper cleaning. That’s the take home message from Australian researchers who assessed microbiological contamination in 16 spirometers from a convenience sample of South Australian general practices. Three of the devices were found to be contaminated, two with Pseudomonas spp., one with coagulase negative Staphylococcus sp., and one with Alcaligenes sp. All of the practices had policies in place governing the cleaning of the spirometers, but the investigators found the frequency of disinfection did not follow recommendations from the manufacturers. The authors conclude, “The potential hazard of spirometers as reservoirs of microorganisms stresses the need for stricter attention to hygiene measures for spirometer maintenance in general practices.” The study appeared in the Jan.-Feb. edition of Australian Family Physician. READ ABSTRACT
